血清HIF-1α、Stathmin、TRAP1水平对全腔镜食管癌手术患者预后的预测价值  

Predictive value of serum HIF-1α,Stathmin and TRAP1 levels in patients undergoing total endoscopic esophageal cancer surgery

作　　者：景鑫 郭海华 杨利博 王成 贠宇辉 姬翔 JING Xin;GUO Haihua;YANG Libo;WANG Cheng;YUN Yuhui;JI Xiang(Department of Thoracic Surgery,the Second Affiliated Hospital of Air Force Medical University,Xi'an,Shaanxi 710038,China;Department of Gastroenterology,the Second Affiliated Hospital of Air Force Medical University,Xi'an,Shaanxi 710038,China)

机构地区：[1]空军军医大学第二附属医院胸腔外科,陕西西安710038 [2]空军军医大学第二附属医院消化内科,陕西西安710038

出　　处：《检验医学与临床》2025年第3期309-313,319,共6页Laboratory Medicine and Clinic

基　　金：陕西省重点研发计划项目(2020SY-307)。

摘　　要：目的探讨联合检测血清缺氧诱导因子-1α(HIF-1α)、微管解聚蛋白(Stathmin)、肿瘤坏死因子受体相关蛋白1(TRAP1)水平在食管癌全腔镜手术患者预后评估中的应用效能。方法选取2021年1月至2022年12月于该院接受食管癌全腔镜手术的109例患者作为研究对象。收集并整理研究对象的临床资料,检测患者HIF-1α、Stathmin、TRAP1水平。随访1年,将出现复发转移、死亡的患者纳入预后不良组,其余纳入预后良好组。绘制受试者工作特征(ROC)曲线分析HIF-1α、Stathmin、TRAP1单独及联合检测对食管癌全腔镜手术患者预后不良的预测价值。采用多因素Logistic回归分析食管癌全腔镜手术患者预后不良的危险因素。结果109例患者中失访0例,随访率为100.00%,随访时间12~36个月,中位随访时间为20个月。其中预后良好78例(71.56%),纳入预后良好组;预后不良31例(28.44%),纳入预后不良组。预后不良组肿瘤最大径大于预后良好组,临床分期为Ⅱ期、分化程度为低、有淋巴结转移、发病部位为颈段食管的患者比例均高于预后良好组,差异均有统计学意义(P<0.05)。术后3 d,预后不良组HIF-1α、Stathmin、TRAP1水平均高于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,术后3 d HIF-1α、Stathmin、TRAP1联合检测预测食管癌全腔镜手术患者预后不良的曲线下面积(AUC)为0.842,高于HIF-1α(0.613)、Stathmin(0.711)、TRAP1(0.759)单独检测的AUC(P<0.05)。多因素Logistic回归分析结果显示,术后3 d HIF-1α、Stathmin、TRAP1水平升高均是食管癌全腔镜手术患者预后不良的危险因素(P<0.05)。结论术后3 d血清HIF-1α、Stathmin、TRAP1均在食管癌全腔镜手术预后不良患者中高表达,3项指标联合检测能提高食管癌全腔镜手术患者预后预测结果的准确度。Objective To investigate the application efficacy of combined detection of serum hypoxia-inducible factor-1α(HIF-1α),microtubule depolymerizing protein(Stathmin)and tumor necrosis factor receptor-associated protein 1(TRAP1)levels in the prognosis evaluation of esophageal cancer after total endoscopic surgery.Methods A total of 109 patients with esophageal cancer who underwent totally endoscopic surgery in the hospital from January 2021 to December 2022 were selected as the research objects.The clinical data of the subjects were collected and sorted out,and the levels of HIF-1α,Stathmin,and TRAP1 were detected.After 1 year of follow-up,patients with recurrence,metastasis or death were included in the poor prognosis group,and the rest were included in the good prognosis group.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of HIF-1α,Stathmin and TRAP1 alone and their combination in the poor prognosis of esophageal cancer after total endoscopic surgery.Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in patients undergoing total endoscopic surgery.Results None of the 109 patients were lost to follow-up,and the follow-up rate was 100.00%.The follow-up time was 12-36 months,with a median follow-up time of 20 months.Among them,78 cases(71.56%)had good prognosis and were included in the good prognosis group.Thirty-one patients(28.44%)had poor prognosis and were included in the poor prognosis group.The maximum diameter of tumor in the poor prognosis group was larger than that in the good prognosis group,and the proportion of patients with clinical stageⅡ,poor differentiation,lymph node metastasis and cervical esophagus in the poor prognosis group was higher than that in the good prognosis group,and the differences were statistically significant(P<0.05).The levels of HIF-1α,Stathmin,and TRAP1 in the poor prognosis group were higher than those in the good prognosis group at 3 d after operation,and the differences were statistically sign

关 键 词：食管癌 全腔镜手术 缺氧诱导因子 微管解聚蛋白 肿瘤坏死因子受体相关蛋白 

分 类 号：R735.1[医药卫生—肿瘤] R446.9[医药卫生—临床医学]